Healthcare Provider Details

I. General information

NPI: 1902269285
Provider Name (Legal Business Name): NEIL JOSE REGALADO ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2016
Last Update Date: 04/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 SWAN LN
ALTAMONTE SPRINGS FL
32701-7669
US

IV. Provider business mailing address

707 SWAN LN
ALTAMONTE SPRINGS FL
32701-7669
US

V. Phone/Fax

Practice location:
  • Phone: 407-923-2177
  • Fax:
Mailing address:
  • Phone: 407-923-2177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9181241
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: